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All About Parkinson's disease
Parkinson's disease (PD also known as idiopathic or primary parkinsonism, hypokinetic rigid syndrome/HRS, or paralysis agitans) is a degenerative disorder of the central nervous system
The motor symptoms of Parkinson's disease result from the death of dopamine-generating cells in the substantia nigra, a region of the midbrain; the cause of this cell death is unknown
Early in the course of the disease, the most obvious symptoms are movement-related; these include shaking, rigidity, slowness of movement and difficulty with walking and gait
Later, thinking and behavioral problems may arise, with dementia commonly occurring in the advanced stages of the disease, whereas depression is the most common psychiatric symptom
Other symptoms include sensory, sleep and emotional problems
Parkinson's disease is more common in older people, with most cases occurring after the age of 50.
The main motor symptoms are collectively called parkinsonism, or a "parkinsonian syndrome"
Parkinson's disease is often defined as a parkinsonian syndrome that is idiopathic (having no known cause), although some atypical cases have a genetic origin
Many risk and protective factors have been investigated: the clearest evidence is for an increased risk of PD in people exposed to certain pesticides and a reduced risk in tobacco smokers
The pathology of the disease is characterized by the accumulation of a protein called alpha-synuclein into inclusions called Lewy bodies in neurons, and from insufficient formation and activity of dopamine produced in certain neurons within parts of the midbrain
Lewy bodies are the pathological hallmark of the idiopathic disorder, and the distribution of the Lewy bodies throughout the Parkinsonian brain varies from one individual to another
The anatomical distribution of the Lewy bodies is often directly related to the expression and degree of the clinical symptoms of each individual
Diagnosis of typical cases is mainly based on symptoms, with tests such as neuroimaging being used for confirmation.
Modern treatments are effective at managing the early motor symptoms of the disease, mainly through the use of levodopa and dopamine agonists
As the disease progresses and dopaminergic neurons continue to be lost, these drugs eventually become ineffective at treating the symptoms and at the same time produce a complication called dyskinesia, marked by involuntary writhing movements
Diet and some forms of rehabilitation have shown some effectiveness at alleviating symptoms
Surgery and deep brain stimulation have been used to reduce motor symptoms as a last resort in severe cases where drugs are ineffective
Research directions include investigations into new animal models of the disease and of the potential usefulness of gene therapy, stem cell transplants and neuroprotective agents
Medications to treat non-movement-related symptoms of PD, such as sleep disturbances and emotional problems, also exist.
The disease is named after the English doctor James Parkinson, who published the first detailed description in An Essay on the Shaking Palsy in 1817
Several major organizations promote research and improvement of quality of life of those with the disease and their families
Public awareness campaigns include Parkinson's disease day (on the birthday of James Parkinson, 11 April) and the use of a red tulip as the symbol of the disease
People with parkinsonism who have increased the public's awareness include actor Michael J
Fox, Olympic cyclist Davis Phinney and professional boxer Muhammad Ali.